License holder summary

BLACKWELL JERRY DALE is a Medical licensed to practice in Louisiana. The address on file for BLACKWELL JERRY DALE is THIBODAUX HIGH SCHOOL, 1355 TIGER DR, THIBODAUX, LA 70301.

Louisiana

Board of Licensing

BLACKWELL JERRY DALE
Medical
License number
ATH.J00235
Date expires
06/30/2015
Class
Medical
Status
Active
Address
THIBODAUX HIGH SCHOOL, 1355 TIGER DR, THIBODAUX, LA 70301
louisianalicensing.com
ID 21761172
LAST UPDATED 2021-09-12 10:30:34 UTC

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